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Protecting Your Right To Life Insurance Benefits

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Life insurance companies deny claims following the death of an insured for a multitude of reasons. If you are a beneficiary of a life insurance policy and have experienced a denial, or feel like the insurance company is about to deny the claim, you need to contact an experienced life insurance attorney right away.

When a loved one passes away unexpectedly, the furthest thing from anyone’s mind is life insurance. Life insurance is bought as a way to protect one’s family from financial hardship should the unthinkable happen. Going through the difficulties of having one’s life insurance claim denied places additional stress and anxiety on the already over-wrought family members. Insurance companies will cite various provisions of the policy, erroneous misstatements on the claim documents or even circumstances surrounding the death as justifications for denying claims. Oftentimes, the evidence cited as reasons for denial is completely immaterial to the claim itself. Insurance companies have the resources and manpower to continue fighting with claimants, who simply want what is owed to them under the contract.

If your life insurance claim has been denied, we at McDermott Law are here to help. To arrange a free Review of Denied Claims, complete our contact form or call 303-964-1800. From our Denver, Colorado, office, we serve clients throughout the Rocky Mountain region.

Supplemental Life Insurance

If the life insurance coverage for your deceased loved one was obtained through an employer, there may have been an opportunity to supplement the basic life insurance with supplemental coverage. Supplemental coverage can be purchased at two, three or more multiples of the basic coverage. If you have not done so, check with the employer and the insurer to determine if supplemental coverage was purchased.

Life Insurance Waiver Of Premium

Your group life insurance policy may contain a provision commonly referred to as a “life waiver of premium” (“LWOP”) or “extension of death benefit” (“EODB”). If so, such a provision provides the insured with the right to continue life insurance coverage under the group policy if her or she is “disabled.” The coverage will continue so long as this person continues to meet the definition of disability (as found in the life policy and not necessarily the definition found in an accompanying long-term disability policy) and even if the employee is no longer employed with that employer. In order to be “disabled” under most life insurance policies’ waiver of premium provision, one typically must prove the inability to perform the material and substantial duties of “any occupation.” Even if an LWOP or EODB does not exist in your policy, you may be able to convert or port your policy to an individual policy due to your disability with the payment of a premium such that you can continue coverage.

In order to obtain ongoing life insurance coverage under an LWOP, EODB or conversion/portability provision, most employers or insurance companies will require that you submit a separate claim under the life insurance policy, specifically claiming ongoing coverage. You will need to retrieve the application from your human resources department.

Suicide Exclusion and Intoxication

Most life insurance policies contain a limitation known as a suicide provision or suicide clause. Such a provision outlines the circumstances for which a claim will or will not be paid if the insured person chooses to commit suicide. If a suicide occurs before the limitation is reached, the claim by the beneficiary will likely be denied. Most policies provide that the suicide provision is only valid for the first two years of coverage. If suicide occurs after that limiting time frame, then the claim cannot be denied because of suicide. Most states’ insurance laws limit such provisions to not lasting more than two years. In Colorado, for instance, the exclusion provision is not enforceable if it’s longer than one year.

But, even if a suicide does occur within the time frame noted in the suicide clause, the claim may still be payable, in Colorado, and perhaps in other states.

In 2018, the Colorado Supreme Court ruled in Renfandt v. New York Life Insurance Company, that, “under Colorado law, a life insurance policy exclusion for ‘suicide, sane or insane’ excludes coverage only if the insured, whether sane or insane at the time, committed an act of self-destruction with the intent to kill himself.” 2018 CO 49, ¶ 53. So, according to the Court, if the insured’s intoxication renders the insured unable to “understand the physical nature and consequences of the act, then he did not intentionally kill himself. In that event, there is simply no ‘suicide.’” As a result, the insurance company is required to investigate and answer that very question if there is any suggestion of intoxication. Many insurers will not bother to conduct an appropriate investigation and, thus, wrongly deny the claim.

Contact Us

If you have been denied your claim for the proceeds from a life insurance policy for which you are the named beneficiary, email the Denver life insurance attorneys at McDermott Law or call 303-964-1800 for a free Review of Denied Claims.

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